Healthcare Transaction Management

We offer financial and clinical risk management
solutions to both funders and providers of healthcare, through
online real-time management of healthcare transactions.

Our adaptable healthcare claims processing and
managed care services are designed to accommodate the complex
benefit design as well as other processing requirements of our
clients and our functionality extends to all healthcare claim
types, including pharmacy, doctor, public and private hospital
claims.

Our service is enabled by our proprietary claims
processing and managed care systems that adjudicate medical claims
allowing patients and healthcare providers to have immediate and
accurate information on the financial and clinical impacts of, and
payment responsibilities for services and products provided by
healthcare providers.

Our proprietary software allows for real-time claim
adjudication involving the submission of an electronic data
interchange claim and receipt of a response with the adjudication
details within seconds.

Our system allows for real-time messaging with an
immediate response to an enquiry within a single, synchronous
communication session.

Our intellectual property incorporates "rule
stacking" technology that allows for the creation of a rule for a
specific patient for a specific healthcare product or service,
which rule is then used to adjudicate against in real-time.

This unique technology offers complex rule
applications in a scalable and flexible manner on all medical claim
types - it is a heuristic computerized framework that dynamically
creates scenario-specific rules.